[Current treatment of bladder exstrophy].

The treatment of vesical exstrophy has greatly improved over the last twenty years. The most important progresses are: closing the bladder before the 72nd hour of life; iliac osteotomy allowing fusion of the pubis when closing the bladder; lengthening of the penis by liberation of the corpora cavernosa; entero-cystoplasty when the reconstructed bladder is too small. Most surgeons practice the same timing for the different operations. Urinary and genital anomalies can be cured at the same time. In relation to urinary problems, about 80% of cases achieve good continence. An urinary diversion, using "Coffey's" technique, must be performed in the presence of incontinence. Concerning genital problems in boys and girls, reconstructive surgery allows restoration of almost normal genital organs. Intercourse seems to be satisfactory in most cases. There is a high sterility rate in men.